Basic Information
| Provider Information | |||||||||
| NPI: | 1841573359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMSON | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MSSW,LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 645 S ROGERS ST | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 474032353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123391691 | ||||||||
| FaxNumber: | 8123372438 | ||||||||
| Practice Location | |||||||||
| Address1: | 1530 N COMMERCE WEST DR | ||||||||
| Address2: | |||||||||
| City: | GREENSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472403205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8126637057 | ||||||||
| FaxNumber: | 8126636735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2011 | ||||||||
| LastUpdateDate: | 04/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 33006219A | IN | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 34007021A | IN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.